Individual
MR. LOUIS JORDAN IRWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
0420008251
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00029589
BLUE SHIELD
VT
05
—
0VN2424
—
VT
01
—
8001321
LADIES FIRST
VT
01
—
833580
MVP
VT
Enumeration date
11/01/2006
Last updated
04/01/2008
Update your record
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